{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T23:27:06Z","timestamp":1781047626105,"version":"3.54.1"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The Triple Elimination initiative is a global effort aimed at eliminating vertical transmission of HIV, hepatitis B and syphilis. This paper describes HIV, syphilis and hepatitis B testing and diagnosis in young women and men accessing sexual and reproductive health services and identifies opportunities to integrate prevention interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was conducted in eight primary healthcare and four mobile clinics in South Africa, integrating HIV PrEP within prevention services. Programme data were collected and analysed from women and men \u226515 years accessing services for the first time between June 2023 and March 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 10,007 clients, 89.4% were female and 65.5% 18\u250024 years. Overall, 70.9% were provided HIV PrEP. Among females, 16.8% were provided contraceptives for the first time. HIV was identified in 1.2% of males and 2.2% of females tested and with results available, syphilis in 5.6% and 5.0%, and hepatitis B in 1.7% and 0.9% respectively. An HIV diagnosis was less likely among older age groups and those enrolled in school and more likely among those with part-time relative to full-time employment. Syphilis was less likely among older age groups and those reporting consistent condom use. Hepatitis B was more likely among those who had used oral PrEP before.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Opportunities for integrated prevention interventions, aligned to triple elimination, include condom programming, contraception, point-of-care testing, PrEP and vaccination. Integrated care delivered through HIV prevention programmes provides an opportunity to treat and prevent HIV, syphilis and hepatitis B, and offer contraception to prevent unintended pregnancies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/frph.2025.1637573","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:32:42Z","timestamp":1758173562000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The contribution of PrEP programmes to triple elimination efforts: a cross-sectional study of status and opportunities"],"prefix":"10.3389","volume":"7","author":[{"given":"Catherine E.","family":"Martin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hlologelo","family":"Ramatsoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nthabiseng","family":"Koloane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maletsatsi","family":"Monametsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Arries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Pleaner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saiqa","family":"Mullick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"B1","volume-title":"Implementing the Global Health Sector Strategies on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2022\u20132030: Report on Progress and Gaps 2024","year":"2024"},{"key":"B2","volume-title":"WHO Syphilis Estimates 2016\u20132022","year":"2024"},{"key":"B3","doi-asserted-by":"publisher","first-page":"287","DOI":"10.2471\/BLT.20.272559","article-title":"Eliminating mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B in Sub-Saharan Africa","volume":"99","author":"Cohn","year":"2021","journal-title":"Bull World Health Organ"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e447","DOI":"10.1016\/S2214-109X(24)00506-0","article-title":"Vertical transmission of hepatitis B virus in the WHO African region: a systematic review and meta-analysis","volume":"13","author":"Riches","year":"2025","journal-title":"Lancet Glob Health"},{"key":"B5","volume-title":"The Path That Ends AIDS: UNAIDS Global AIDS Update 2023","year":"2023"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e0012622","DOI":"10.1128\/cmr.00126-22","article-title":"Congenital syphilis: a review of global epidemiology","volume":"36","author":"Gilmour","year":"2023","journal-title":"Clin Microbiol Rev"},{"key":"B7","volume-title":"Introducing a Framework for Implementing Triple Elimination of Mother-to-child transmission of HIV, Syphilis and Hepatitis B Virus: Policy Brief","year":"2023"},{"key":"B8","volume-title":"PrEP Watch: The Global PrEP Tracker","year":"2022"},{"key":"B9","doi-asserted-by":"publisher","first-page":"S58","DOI":"10.1016\/j.jadohealth.2023.09.003","article-title":"Implementing differentiated and integrated HIV prevention services for adolescent girls and young women: experiences from oral PrEP rollout in primary care services in South Africa","volume":"73","author":"Butler","year":"2023","journal-title":"J Adolesc Health"},{"key":"B10","volume-title":"National HIV Testing Services: Policy","year":"2016"},{"key":"B11","volume-title":"Updated Guidelines for the Provision of Oral pre-exposure prophylaxis (PrEP) to Persons at Substantial Risk of HIV Infection","year":"2021"},{"key":"B12","volume-title":"Comprehensive STI Clinical Management Guidelines 2021\u20132025","year":"2021"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2302","DOI":"10.1002\/sim.7273","article-title":"Firth\u2019s logistic regression with rare events: accurate effect estimates and predictions?","volume":"36","author":"Puhr","year":"2017","journal-title":"Stat Med"},{"key":"B14","volume-title":"Stata Statistical Software: Release 18.","year":"2023"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1093\/ije\/dyn131","article-title":"Keep them in school: the importance of education as a protective factor against HIV infection among young South African women","volume":"37","author":"Pettifor","year":"2008","journal-title":"Int J Epidemiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e0279289","DOI":"10.1371\/journal.pone.0279289","article-title":"HIV incidence and associated risk factors in adolescent girls and young women in South Africa: a population-based cohort study","volume":"17","author":"Lewis","year":"2022","journal-title":"PLoS One"},{"key":"B17","volume-title":"Condoms","year":"2024"},{"key":"B18","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1007\/s10461-021-03366-x","article-title":"Delivering PrEP to young women in a low-income setting in South Africa: lessons for providing both convenience and support","volume":"26","author":"Cassidy","year":"2022","journal-title":"AIDS Behav"},{"key":"B19","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1080\/09540121.2020.1822505","article-title":"Persistence of oral pre-exposure prophylaxis (PrEP) among adolescent girls and young women initiating PrEP for HIV prevention in Kenya","volume":"33","author":"de Dieu Tapsoba","year":"2021","journal-title":"AIDS Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e0258542","DOI":"10.1371\/journal.pone.0258542","article-title":"Adolescent girls and young women\u2019s PrEP-user journey during an implementation science study in South Africa and Kenya","volume":"16","author":"Rousseau","year":"2021","journal-title":"PLoS One"},{"key":"B21","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1186\/s12905-022-02018-z","article-title":"Uptake of and adherence to oral pre-exposure prophylaxis among adolescent girls and young women at high risk of HIV-infection in Kampala, Uganda: a qualitative study of experiences, facilitators and barriers","volume":"22","author":"Kayesu","year":"2022","journal-title":"BMC Womens Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e26249","DOI":"10.1002\/jia2.26249","article-title":"Experiences of oral pre-exposure prophylaxis use among heterosexual men accessing sexual and reproductive health services in South Africa: a qualitative study","volume":"27","author":"Cholo","year":"2024","journal-title":"J Int AIDS Soc"},{"key":"B23","doi-asserted-by":"publisher","first-page":"S75","DOI":"10.1097\/QAD.0000000000003242","article-title":"Assessing layered HIV prevention programming: optimizing outcomes for adolescent girls and young women","volume":"36","author":"Mathur","year":"2022","journal-title":"AIDS"},{"key":"B24","volume-title":"South Africa Demographic and Health Survey 2016. Pretoria, South Africa and Rockville","year":"2019"},{"key":"B25","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.contraception.2022.07.005","article-title":"Participation in an HIV prevention intervention and access to and use of contraceptives among young women: a cross sectional analysis in six South African districts","volume":"116","author":"Jonas","year":"2022","journal-title":"Contraception"},{"key":"B26","doi-asserted-by":"publisher","first-page":"307","DOI":"10.7196\/SAMJ.2017.v107i4.12141","article-title":"Contraception coverage and methods used among women in South Africa: a national household survey","volume":"107","author":"Chersich","year":"2017","journal-title":"S Afr Med J"},{"key":"B27","volume-title":"South African National HIV Prevalence, Incidence and Behaviour Survey, 2012","author":"Shisana","year":"2014"},{"key":"B28","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1186\/s12889-021-10570-w","article-title":"The role of contraception in preventing HIV-positive births: global estimates and projections","volume":"21","author":"Sherwood","year":"2021","journal-title":"BMC Public Health"},{"key":"B29","doi-asserted-by":"publisher","first-page":"ii54","DOI":"10.1136\/sti.2008.030098","article-title":"From effectiveness to impact: contraception as an HIV prevention intervention","volume":"84","author":"Wilcher","year":"2008","journal-title":"Sex Transm Infect"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e25426","DOI":"10.1002\/jia2.25426","article-title":"Emerging evidence from a systematic review of safety of pre-exposure prophylaxis for pregnant and postpartum women: where are we now and where are we heading?","volume":"23","author":"Joseph Davey","year":"2020","journal-title":"J Int AIDS Soc"},{"key":"B31","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/S0140-6736(19)31288-7","article-title":"HIV incidence among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: a randomised, multicentre, open-label trial","volume":"394","author":"Ahmed","year":"2019","journal-title":"Lancet"},{"key":"B32","doi-asserted-by":"publisher","first-page":"684114","DOI":"10.3389\/frph.2021.684114","article-title":"Uptake of contraception among adolescent girls and young women PrEP clients: leveraging the opportunity to strengthen HIV and sexual and reproductive health integration","volume":"3","author":"Pleaner","year":"2021","journal-title":"Front Reprod Health"},{"key":"B33","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1186\/s12879-022-07534-9","article-title":"Facilitators and barriers to point-of-care testing for sexually transmitted infections in low- and middle-income countries: a scoping review","volume":"22","author":"Martin","year":"2022","journal-title":"BMC Infect Dis"},{"key":"B34","volume-title":"Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022\u20132030","year":"2022"},{"key":"B35","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1136\/sextrans-2016-053069","article-title":"A systematic review and meta-analysis of studies evaluating the performance and operational characteristics of dual point-of-care tests for HIV and syphilis","volume":"93","author":"Gliddon","year":"2017","journal-title":"Sex Transm Infect"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.4102\/sajhivmed.v25i1.1571","article-title":"Acceptability and performance of dual HIV\/syphilis testing in male circumcision clients, 2021","volume":"25","author":"Kufa","year":"2024","journal-title":"South Afr J HIV Med"},{"key":"B37","volume-title":"National Guidelines for the Management of Viral Hepatitis","year":"2020"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e1473","DOI":"10.7196\/SAMJ.2024.v114i2.1473","article-title":"The role of new hepatitis B vaccines in South Africa","volume":"114","author":"Van Zyl","year":"2024","journal-title":"S Afr Med J"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e26218","DOI":"10.1002\/jia2.26218","article-title":"What does the scale-up of long-acting HIV pre-exposure prophylaxis mean for the global hepatitis B epidemic?","volume":"27","author":"Mohareb","year":"2024","journal-title":"J Int AIDS Soc"},{"key":"B40","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/S2468-1253(18)30270-X","article-title":"Accelerating the elimination of viral hepatitis: a lancet gastroenterology & hepatology commission","volume":"4","author":"Cooke","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"e0181267","DOI":"10.1371\/journal.pone.0181267","article-title":"Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: a South African experience","volume":"12","author":"Chotun","year":"2017","journal-title":"PLoS One"},{"key":"B42","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1186\/s12879-022-07697-5","article-title":"Low prevalence of hepatitis B virus infection in HIV-uninfected pregnant women in Cape Town, South Africa: implications for oral pre-exposure prophylaxis roll out","volume":"22","author":"Joseph Davey","year":"2022","journal-title":"BMC Infect Dis"},{"key":"B43","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1186\/s12879-023-08324-7","article-title":"Secondary distribution of HIV self-test kits by HIV index and antenatal care clients: implementation and costing results from the STAR initiative in South Africa","volume":"22","author":"Zishiri","year":"2023","journal-title":"BMC Infect Dis"},{"key":"B44","volume-title":"Updated Recommendations for the Treatment of Neisseria gonorrhoeae, Chlamydia trachomatis and Treponema pallidum (syphilis), and new Recommendations on Syphilis Testing and Partner Services","year":"2024"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e25298","DOI":"10.1002\/jia2.25298","article-title":"HIV pre-exposure prophylaxis for adolescent girls and young women in Africa: from efficacy trials to delivery","volume":"22","author":"Celum","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"B46","doi-asserted-by":"publisher","first-page":"e25588","DOI":"10.1002\/jia2.25588","article-title":"Uptake and retention on HIV pre-exposure prophylaxis among key and priority populations in South-Central Uganda","volume":"23","author":"Kagaayi","year":"2020","journal-title":"J Int AIDS Soc"},{"key":"B47","volume-title":"Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach","year":"2021"},{"key":"B48","doi-asserted-by":"publisher","first-page":"e528","DOI":"10.1016\/S2468-2667(21)00112-2","article-title":"HIV pre-exposure prophylaxis: scaling up for impact now and in the future","volume":"6","author":"Bavinton","year":"2021","journal-title":"Lancet Public Health"},{"key":"B49","doi-asserted-by":"publisher","first-page":"e585","DOI":"10.1016\/S2352-3018(22)00123-0","article-title":"Risks and benefits of oral HIV pre-exposure prophylaxis for people with chronic hepatitis B","volume":"9","author":"Mohareb","year":"2022","journal-title":"Lancet HIV"},{"key":"B50","volume-title":"Global Hepatitis Report 2024: Action for Access in low- and Middle-income countries","year":"2024"},{"key":"B51","doi-asserted-by":"publisher","first-page":"6025","DOI":"10.3748\/wjg.v27.i36.6025","article-title":"Hepatitis B virus infection and hepatocellular carcinoma in sub-saharan Africa: implications for elimination of viral hepatitis by 2030?","volume":"27","author":"Amponsah-Dacosta","year":"2021","journal-title":"World J Gastroenterol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12889-021-12391-3","article-title":"Prevalence and incidence rates of laboratory-confirmed hepatitis B infection in South Africa, 2015 to 2019","volume":"22","author":"Moonsamy","year":"2022","journal-title":"BMC Public Health"},{"key":"B53","volume-title":"Guideline for Vertical Transmission Prevention of Communicable Infections","year":"2023"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2025.1637573\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:32:46Z","timestamp":1758173566000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2025.1637573\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":53,"alternative-id":["10.3389\/frph.2025.1637573"],"URL":"https:\/\/doi.org\/10.3389\/frph.2025.1637573","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]},"article-number":"1637573"}}